Chronic liver failure

Patients with compensated chronic liver failure (without ascites, variceal bleeding, encephalopathy, or jaundice) have a median survival of 12 years. After decompensation, median survival drops to ~2 years.

Validated prognostic indices for patients without liver transplantation provide objective guidance to prognostication in liver failure.Childs-Turcotte-Pugh(CTP) calculator. It relies on encephalopathy, ascites, bilirubin, albumin, and international normalized ratio. Patients are grouped into three classes based on the total CTP score, which is the sum of the scores for five variables. Patients scoring:
- 5-6 points (Class A failure): 1- and 2-year median survivals are 95% and 90%, respectively.
- 7-9 points (Class B failure): 1- and 2-year median survivals are 80% and 70%, respectively.
- 10-15 points (Class C failure): 1- and 2-year median survivals are 45% and 38 %, respectively.

The CTP calculator can be found at https://www.hepatitisc.uw.edu/page/clinical-calculators/ctp

Model for End-Stage Liver Disease (MELD) score. The MELD score relies on laboratory values alone (serum creatinine, total bilirubin, and INR); it can predict prognosis with more precision. The MELD calculator can be found at https://reference.medscape.com/calculator/meld-score-end-stage-liver-disease

​Disclaimer. Pallipedia does not endorse or recommend any commercial products, processes, or services; therefore, their mention cannot be construed as such. Pallipedia should not be used as guidance to treatment and its purpose is to provide users with information to help them better understand conditions and the current range of approaches related to palliative care. Pallipedia urges health care providers and patients to always consult other relevant and up-to-date experts.